The quantitative association of plasma endotoxin, antithrombin, protein C, extrinsic pathway inhibitor and fibrinopeptide A in systemic meningococcal disease

Thrombosis Research
Petter BrandtzaegPeter Kierulf

Abstract

We have evaluated the quantitative relationship between lipopolysaccharide (LPS, endotoxin), fibrinopeptide A (FPA), antithrombin (AT), protein C (PC) and extrinsic pathway inhibitor (EPI) in plasma from 39 consecutively admitted patients with systemic meningococcal disease (SMD). The most severely ill patients with fulminant meningococcal septicemia (n = 13, 6 dead) had significantly (p less than 0.01) higher plasma levels of LPS and FPA and lower levels of PC and AT on admission as compared with the less severe clinical presentations (n = 26, 1 dead). The levels of EPI on admission were significantly (p less than 0.05) higher in nonsurvivors vs survivors with fulminant septicemia. As the disease progressed, the levels of LPS, FPA, AT and PC declined, while the levels of EPI increased. Three of six nonsurviving septicemic patients had levels of EPI greater than 200% within 16 hours of admission vs two of 30 survivors (p = 0.02). The results suggest that increasing levels of LPS in SMD elicit increasing consumption coagulopathy, contributing to the organ pathophysiology. The kinetics of EPI, inhibiting the thromboplastin-FVIIa-FXa complex, differs markedly from the kinetics of AT and PC i.e. increases as opposed to decreases.

References

Jul 1, 1989·The Journal of Infectious Diseases·P BrandtzaegP Kierulf
Feb 1, 1989·The Journal of Infectious Diseases·P BrandtzaegE Sørensen
Aug 27, 1987·The New England Journal of Medicine·D R PowarsR B Francis
May 15, 1986·Thrombosis Research·A R Hubbard, C A Jennings
Sep 1, 1987·Reviews of Infectious Diseases·E F Lüscher
Jun 15, 1988·Thrombosis Research·P M SandsetM L Larsen
Jan 1, 1987·Haemostasis·O R OdegaardT R Andersson
Jan 1, 1986·Vox Sanguinis·O H SkjønsbergH C Godal
Jul 1, 1974·The Journal of Clinical Investigation·H L NosselG D Qureshi
Aug 1, 1967·Annals of Internal Medicine·W G McGeheeP F Hjort
Jun 1, 1969·The American Journal of Medicine·R W EvansM Bobell
Jul 28, 1984·British Medical Journal·R S PedersenK Stengaard-Petersen
Nov 1, 1983·Scandinavian Journal of Haematology·G Frantzen HandelandA O Aasen

❮ Previous
Next ❯

Citations

Jan 1, 1993·Intensive Care Medicine·L G ThijsC E Hack
Jan 1, 1993·Immunologic Research·J FigueroaP Densen
Apr 22, 2005·European Journal of Pediatrics·Gotho GeishoferUNKNOWN Central European Meningococcal Genetic Study Group
Jun 15, 2007·Human Genetics·Alexander BinderUNKNOWN Central European Meningococcal Genetic Study Group
Apr 18, 1992·Journal of Immunological Methods·R S MunfordP D Rick
Jul 1, 1995·Trends in Cardiovascular Medicine·C T Esmon, H P Schwarz
Apr 1, 1995·The Journal of Pediatrics·G E RivardH P Schwarz
Feb 28, 2002·Thrombosis Research·Nina IversenUlrich Abildgaard
Apr 5, 2003·Thrombosis Research·Nina IversenUlrich Abildgaard
Apr 4, 1998·Thrombosis Research·T UlutinG Sultuybek
Sep 12, 1998·British Journal of Haematology·N IversenU Abildgaard
Mar 2, 1999·British Journal of Haematology·O P Smith, B White
Aug 10, 2002·Acta medica Austriaca·Ch Pechlaner
Aug 11, 2001·The New England Journal of Medicine·S N FaustR S Heyderman
Dec 19, 2002·British Journal of Anaesthesia·P B Baines, C A Hart
Nov 1, 1996·The Pediatric Infectious Disease Journal·E A KirschB P Giroir
Mar 4, 2000·Pediatric Emergency Care·G BriassoulisT Hatzis
Apr 18, 2001·Journal of Pediatric Hematology/oncology·A Gurgey, D Aslan
Jun 10, 2003·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Trung NguyenJoseph A. Carcillo
Jan 11, 2000·Clinical Microbiology Reviews·M van DeurenJ W van der Meer
Jun 24, 2003·Archives of Disease in Childhood·N PathanM Levin
Feb 27, 2008·Critical Care : the Official Journal of the Critical Care Forum·Burkhard VangerowKonrad Reinhart
Apr 9, 2008·Critical Care : the Official Journal of the Critical Care Forum·Andrew F ShorrJonathan Janes
Jan 6, 2009·Critical Care : the Official Journal of the Critical Care Forum·Tom van der Poll
Jul 21, 2007·The American Journal of Pathology·Haiwang TangFlorea Lupu
Oct 18, 2008·Journal of Medical Microbiology·Alexandre Leite de Souza, Antonio Carlos Seguro
Aug 13, 2015·The New England Journal of Medicine·Theodore E Warkentin
Oct 3, 2003·Expert Opinion on Pharmacotherapy·Christopher James DoigBraden J Manns
Oct 20, 2001·Disease-a-month : DM·P E Marik, J Varon

❮ Previous
Next ❯

Related Concepts

Related Feeds

ApoE, Lipids & Cholesterol

Serum cholesterol, triglycerides, apolipoprotein B (APOB)-containing lipoproteins (very low-density lipoprotein (VLDL), immediate-density lipoprotein (IDL), and low-density lipoprotein (LDL), lipoprotein A (LPA)) and the total cholesterol/high-density lipoprotein (HDL) cholesterol ratio are all connected in diseases. Here is the latest research.